(Your LCCC email address begins with the username for your MyCampus account and ends in @mail.lorainccc.edu)

Personal Email Address *

Semester *

Semester

Fall

Spring

Summer

Year *

Current Major *

Curriculum Code (4-digit number) *

Complete the following questions if you are changing your major:

New Major

New Curriculum Code (4-digit number)

If this is a University Partnership Program, please provide the information below.

University Name

UP Program Name

Number of credit hours to be certified this semester* *

* Only classes that are listed on your curriculum guide for your program will be approved.

GI Bill Benefit Chapter *

If you are a new student, have you used your G.I. Benefits at another college?

If you are a new student, have you used your G.I. Benefits at another college?

Yes

No

Note: If so, you will need to complete VA Form: 22-1995 Change of Program/Place of Training.

Is this the first time you are submitting your schedule for this semester? *

Is this the first time you are submitting your schedule for this semester?

Yes

No

Note: If you are uncertain if the courses you have registered for are required in your degree, you should consult with your counselor or advisor before requesting enrollment certification.

Have you made any changes to your schedule? *

Have you made any changes to your schedule?

Yes

No

Note: If you stop attending class and receive a failing grade, VA will not pay for that class.

Are you going to graduate at the end of the semester? *

Are you going to graduate at the end of the semester?

Yes

No

I hereby acknowledge the following and will report immediately to the VA Certifying Official at LCCC any changes in my enrollment:

• Submitting my request less than eight weeks prior to the term beginning will delay my benefits.
• It is my responsibility to self-verify attendance monthly through VA CERT (Ch 33 & 35 excluded).
• I understand that I must remain in good academic standing to be certified as outlined in the Veterans’ Standards of Progress policy stated in the LCCC Catalog.
• I understand that all courses I am registered for must apply to my degree program and be approved by an Academic Advisor, and if I change courses after I have submitted this initial request, that I must submit a new Veteran’s Certification request for approval for these changed courses. This does not guarantee approval.
• I understand that if I stop attending a class, withdraw, or drop classes that a debt may be incurred.
• If I take courses in an 8 or 10 week format in a regular semester (not summer) it may impact my VA funding.
• I understand that I must read all information on the Veteran’s webpage and understand my obligations about attending classes and keeping good grades.
• I understand that the VA does not permit a course to be repeated in which I have earned a grade of D or better except in very special circumstances (Allied Health or Remedial Courses).
• I realize that Physical Education courses will not be certified unless required by my degree program or I am a Chapter 35 (Survivor/Dependent) recipient.
• If I change my major I must complete the appropriate paperwork (VA Form 22-1995).
• I understand that online remedial courses (class numbers starting in zero, ex: MTHM 051) are not approved by VA. Remedial courses can only be taken on campus.

I confirm that I have read and acknowledge my responsibility to the above.

Smart Path FWD

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